A broad population of patients require increased nutrients and energy as a result of suffering from various diseases or insults. For example, patients suffering from traumatic injury, burns, post-surgery, and some disease states have a significant need for increased nutrients and energy as compared to individuals who are not challenged by such metabolic stress.
In fact, non-essential nutrients and substances that a patient's body can typically synthesize in adequate supply, may become limiting when challenged by a metabolic stress. Furthermore, absorption of nutrients from the gut can be compromised even when there is no direct injury to the gastrointestinal system.
Accordingly, patients faced with such metabolic challenges are fed either with parenteral formulations or enteral formulations either to replace or supplement a typical diet. For example, in 1991, of an estimated 2.4 million trauma patients in the United States, 13% (310,000) required nutrition support beyond food. Of these patients, 62% of the patients were supported using enteral nutrition, 70% tube-feeding, and 30% oral supplements, while 38% were initially supported using parenteral nutrition and progressed to tube-feeding, if they survived. Similarly, of about 106,000 burn patient admissions in 1991 in the U.S., approximately 20% (21,000) required nutritional support. Of this group, 95% were started on enteral nutrition, 70% began on tube feeding and 30% started on oral supplements.
Numerous enteral formulations have been targeted for metabolically challenged patients. These products include: Mead-Johnson's Magnacal, Traumacal, and Isocal; Ross's Ensure Plus, Ensure, and Osmolite; and Novartis's Precision Isotein HN. Although such products are used in an attempt to treat and/or provide nutritional requirements, a drawback to these formulations is that they fall short in meeting some of the needs of metabolically challenged patients. Accordingly, there is a need for an enteral formulation which satisfies a greater number of the needs of the metabolically challenged patient.